托莫西汀在注意缺陷多动障碍儿童中的应用

Clinical application of atomoxetine in children with attention deficit hyperactivity disorder

非中枢神经兴奋剂托莫西汀在国内的上市,为注意缺陷多动障碍(ADHD)的药物治疗提供了新的选择。托莫西汀是去甲肾上腺素递质再摄取抑制剂,能选择性抑制突触前去甲肾上腺素转运蛋白,增强去甲肾上腺素的翻转效应,延长在突触裂隙释放的去甲肾上腺素的活性,从而达到改善ADHD患者的症状。与中枢神经兴奋剂哌甲酯相比,因其并不影响多巴胺神经递质的浓度,故不致诱导抽动或加重运动障碍,因而更适宜ADHD合并抽动障碍的患儿选用。文章还就托莫西汀治疗ADHD的适应证、用药剂量调整方法以及不良反应和疗效评估等问题作了概述。

Atomoxetine as a nonstimulant medicine was approved by the Chinese Food an Drug Administration and provide a new selection of treatment drugs for attention deficit hyperactivity disorder （ADHD）. Tomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit synapsis noradrenaline transport protein, strengthen noradrenaline＇s resupination effect, and increase noradrenaline＇s activity released by synaptic cleft to improve the symptoms of the ADHD patients. Compared with methylphenidate, atomoxetine does not affect the concentration of the neurotransmitter dopamine and does not induce or increase the Tourettes＂ syndrome, therefore atomoxetine is more suitable to treat ADHD together with Tourettes＂ syndrome. In this article the treatment of atomoxetine for ADHD, including the indications, dosage as well as adverse reactions and efficacy assessment are reviewed.